1. A. A manager shall ensure that a resident’s representative is designated for a resident who is unable to direct self-care.

2. B. A manager of an assisted living facility authorized to provide directed care services shall not accept or retain a resident who, except as provided in R9-10-814(B)(2):

   1. 1. Is confined to a bed or chair because of an inability to ambulate even with assistance; or
   2. 2. Has a stage 3 or stage 4 pressure sore, as determined by a registered nurse or medical practitioner.

3. C. In addition to the requirements in R9-10-808(A)(3), a manager shall ensure that the service plan for a resident receiving directed care services includes:

   1. 1. The requirements in R9-10-814(F)(1) through (3);
   2. 2. If applicable, the determination in R9-10-814(B)(2)(b)(iii);
   3. 3. Cognitive stimulation and activities to maximize functioning;
   4. 4. Strategies to ensure a resident’s personal safety;
   5. 5. Encouragement to eat meals and snacks;

   6. 6. Documentation:

      1. a. Of the resident’s weight, or
      2. b. From a medical practitioner stating that weighing the resident is contraindicated;
   7. 7. Coordination of communications with the resident’s representative, family members, and, if applicable, other individuals identified in the resident’s service plan; and

   8. 8. If the resident is receiving memory care services:

      1. a. Identification of specialized environmental features to support memory care services, such as secure areas to prevent wandering and spaces designed for cognitive stimulation and engagement;
      2. b. Strategies for providing person-centered care that aligns with the principles of dementia-friendly environments, including familiar surroundings, optimized sensory stimulation, and meaningful activities; and
      3. c. Strategies for administering medications as ordered.
4. D. A manager shall ensure that an employee does not provide non-prescription medication to a resident receiving directed care services unless the resident has an order from a medical practitioner for the non-prescription medication.

5. E. A manager shall ensure that:

   1. 1. A bell, intercom, or other mechanical means to alert employees to a resident’s needs or emergencies is available in a bedroom being used by a resident receiving directed care services; or
   2. 2. An assisted living facility has implemented another means to alert a caregiver or assistant caregiver to a resident’s needs or emergencies.

6. F. A manager of an assisted living facility authorized to provide directed care services shall ensure that:

   1. 1. Policies and procedures are established, documented, and implemented that ensure the safety of a resident who may wander;

   2. 2. There is a means of exiting the facility for a resident who does not have a key, special knowledge for egress, or the ability to expend increased physical effort that meets one of the following:

      1. a. Provides access to an outside area that:

         1. i. Allows the resident to be at least 30 feet away from the facility that is secure, and
         2. ii. Monitors or alerts employees of the egress of a resident from the facility;

      2. b. Provides access to an outside area:

         1. i. From which a resident may exit to a location at least 30 feet away from the facility that is secure, and
         2. ii. Monitors or alerts employees of the egress of a resident from the facility; or
      3. c. Uses a mechanism that meets the Special Egress-Control Devices provisions in the International Building Code incorporated by reference in R9-10-104.01; and
   3. 3. A caregiver or an assistant caregiver complies with the requirements for incidents in R9-10-804 when a resident who is unable to direct self-care wanders into an area not designated by the governing authority for use by the resident.

Historical Note

New Section made by final rulemaking at 9 A.A.R. 319, effective March 14, 2003 (Supp. 03-1). Section repealed; new Section made by exempt rulemaking at 19 A.A.R. 2015, effective October 1, 2013 (Supp. 13-2). Amended by exempt rulemaking at 20 A.A.R. 1409, pursuant to Laws 2013, Ch. 10, § 13; effective July 1, 2014 (Supp. 14-2). Amended by final rulemaking at 25 A.A.R. 1583, effective October 1, 2019 (Supp. 19-3). Amended by final expedited rulemaking, at 25 A.A.R. 3481 with an immediate effective date of November 5, 2019 (Supp. 19-4). Amended by final rulemaking at 31 A.A.R. 2085 (June 27, 2025), with a delayed effective date of June 30, 2025 (Supp. 25-2).